Ch. 9 Effects of CPB

Question 1

Lungs

Answer 1

• most common serious injury on CPB

- prone to injury from blood inflammatory responses to contact activation (C3a, C5a)= activate WBC

Question 2

Pump Lung

Answer 2

congested lungs with intra alveolar edema, interstitial edema, atelectasis= acute respiratory failure

Question 3

Atelectasis

Answer 3

collapse lung

-left lung is more prone- harder to drain

Question 4

Kidney

Answer 4

found in retroperitoneal

-filters blood

Question 5

GFR

Answer 5

glomerular filtration rate= rate of passage of water, electrolytes, small mo
=35 ml/min/m2

Question 6

Indicator for renal function

Answer 6

creatinine= normal 1 mg/100 ml

Question 7

Complement System

Answer 7

• proteins bind to antibodies against infections/foreign
  =Circuit activates C3a, C5a= neutrophil migrations
  =Circuit activates arachidonic acid= increase vascular permeability
  -anaphylatoxins= increase vascular perm, edema, smooth muscle
  -chemotatic factors= WBC migration, inflammation, ROS

Question 8

Endocrine System

Answer 8

duckless glands that secrete hormones into blood

-adrenal, thyroid, parathyroid, pituitary, pancreas, gonads, pineal, thymus

Question 9

Adrenal gland

Answer 9

medulla= epi/norepi= increae BP with vasoconstricion

Question 10

Thryoid

Answer 10

T3/T4= increase contractility, CO, HR, regulate beta, temp, metabolic
- stimulated by thyroid hormone
T3 reduced on CPB= given if can’t wean
T3= half life 2 days
T4= half life 7 days

Question 11

Pituitary and hypothalamus

Answer 11

vasopressin (ADH)= antiduretic - increase BP

Question 12

Pancrease

Answer 12

insulin

-decrease with decrease temp= increase glucose in blood

Question 13

Hepatic

Answer 13

largest organ- 27% of CO

• normal if 2.2 index
• jaundice if liver injury= high bilirubin